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IntroductionAlthough most ischaemic strokes are due to cardioembolism, about 25–40% of strokes are cryptogenic. Patent foramen ovale has been associated with cryptogenic stroke; however, the precise mechanism of this association has not been demonstrated. The aim of this study was to evaluate the association between inflammatory markers and cryptogenic stroke in patients with patent foramen ovale.Material and methodsWe included 206 patients with patent foramen ovale. Ninety-four (45.63%) out of 206 patients had had stroke, and 112 (54.37%) had not had stroke. The ratio of the total neutrophil count to the total lymphocyte count was defined as the neutrophil to lymphocyte ratio, and the ratio of the absolute platelet count to the absolute lymphocyte count was determined as the platelet to lymphocyte count.ResultsThe neutrophil to lymphocyte ratio was significantly higher in patients who had stroke than in those who did not (2.41 ±1.69 vs. 2.19 ±1.74, p = 0.047). Although the platelet to lymphocyte count was also higher in patients who had had stroke than in those who had not, it was not statistically significant (120.94 ±55.45 vs. 118.01 ±52.21, p = 0.729). 1.62 was the cut-off value for neutrophil to lymphocyte ratio to be associated with stroke with 73.4% sensitivity and 45.05% specificity (p = 0.042).ConclusionsThis study demonstrated that elevated neutrophil to lymphocyte ratio and platelet to lymphocyte count could be associated with cryptogenic stroke in patients with patent foramen ovale.

Objective Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4- 5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study. Methods Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC. Results There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group. Conclusion Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.

ABS TRACT: The impact of positive and negative affect on QT dispersion in healthy young adult men Objective: In this study, we aimed to determine whether QT dispersion known to be associated with development of coronary artery disease is related with positive (PA) and negative affect (NA) in healthy young adult men. Method: Two hundred and forty-four healthy males aged between 21-30 years were included in this study. Standard electrocardiographic (12 derivation and 50 mm/sec) and echocardiographic evaluations were performed. The duration of QT dispersion was measured digitally. Patients with sinus bradycardia, sinus tachycardia, bundle branch block, preexcitation and electrolyte imbalances were excluded. PA and NA scores of the subjects were determined by the Positive and Negative Affect Scale and clustered into “high” and “low” affect subtypes. Results: QT dispersion was significantly increased in subjects with high NA compared with those with low NA. There was no difference between the subjects having high PA and low PA. QT dispersion correlated positively with NA but not with PA. Conclusion: The results of this study have shown that there may be a relation between QT dispersion and NA in healthy young adult men.

Objective: In recent research, it has been suggested that cognitive functions seem to be impaired not only during the acute phases of bipolar disorder, but also during remission. In this study, we aimed to investigate cognitive functions in the manic, depressed and remission periods of bipolar disorder by comparing with a healthy control group. Methods: Cognitive functions including attention and memory were examined in 20 manic, 10 depressed and 21 euthymic bipolar I patients (3 months of remission, Hamilton depression scale score?8, and Young Mania Rating Scale score?6) as compared with 22 healthy subjects. All subjects were male, and their ages were between 20-45 years. Cognitive evaluation was carried out by the Serial Digit Learning Test, Auditory Verbal Learning Test, Cancellation Test and Stroop Test. Results: We found that attention, memory and learning functions were worse in the manic and depressive patients than healthy controls or patients in remission and that the number of depressive episodes had a negative effect on attention functions. No difference was found between patients in remission and healthy controls. Some attention subtests scores were negatively related to the memory test and its subtest scores in manic and depressed patients. Conclusion: This study has shown that impairments in attention, memory, information processing and learning functions of bipolar patients were specific to the depressive and manic periods of the disorder and no effect was present in the remission period.

Comorbidity is highly prevalent in post-traumatic stress disorder (PTSD) patients. Treatment methods are often not enough to decrease all of the PTSD symptoms, especially in cases where PTSD is com...

Objective: Especially for patients with chronic diseases, adherence is an important factor that interferes with the success of treatment. There are few reports examining adherence to appointments and medication in diagnostically specific groups such as individuals with schizophrenia. This study aimed to examine the correlates of missed appointments and medication adherence in a sample of persons attending an outpatient schizophrenia follow-up program after hospital discharge. Methods: The study included 132 patients with schizophrenia. Outpatient appointments were planned to occur in the range of every 1 to 8 weeks by taking into consideration the patient’s clinical status. Patients were followed up for a period of two years to assess appointment-keeping behavior and medication adherence. Within this period, patients who did not attend more than 20% of their appointments were evaluated as the “non-attender group.” Results: The rate of patients, who have missed a scheduled appointment, was 44.7% during the chosen period. Non-attendance was related to low educational level and living alone. Before discharge of the patient, the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Positive Symptoms (SAPS) total scores were higher in the non-attender group compared to attender patients. Non-attender patients also had higher numbers of psychiatric hospitalizations and involuntary psychiatric hospitalizations and greater medication non-adherence rates. Conclusion: Sociodemographic factors and clinical features affect patient participation in the appointments. In addition, non-attendance at appointments in particular is closely linked with medication non-adherence.

Aggressive behaviour is associated with reduced serotonin metabolism in the brain, but there is not enough knowledge on potential changes of the serotonin precursor levels among violent offenders. In this study, we aimed to evaluate the relationships among the tendency of psychopathy, anger and the basic amino acids.Fifty-two young adult male patients with antisocial personality disorder (APD) and 30 healthy men included the study. Serum amino acid levels were measured by HPLC method. Aggression questionnaire and Hare Psychopathology Scale were used for all participants.Blood levels of phosphoserine, aspartic acid, glutamic acid, aminoadipic acid and 1-methylhistidine in group of patients with APD were significantly higher than the control group. Blood levels of TRP, asparagine, citrulline, cystine, isoleucine, tyrosine, histidine, hydroxylysine, lysine, ethanolamine and arginine in the group of patients were found lower than the control group. A significant positive correlation between anger scores and histidine, methionine and GABA was found. GABA and methionine showed a significant correlation with the indirect aggression score.Our study showed a relationship between serum amino acid levels and the scores of aggression and psychopathy. We think that this is a productive research area for understanding the relationship among biochemical factors, aggression and psychopathy.

The present study was designed to describe the socio-demographic, clinical, and polysomnographic features of patients diagnosed with narcolepsy in our sleep center. This retrospective cross-sectional study was conducted on 181 patients diagnosed with narcolepsy based on the results of clinical evaluation, polysomnography (PSG), and multiple sleep latency test (MSLT) between 1993 and 2009. Approximately 70% of the patients had cataplexy, whereas 42% had hallucinations and 55.8% had sleep paralysis. Although sleep efficiency was higher (91.28 ± 5.89%) in patients with narcolepsy, they woke frequently during the night, and their percentages of deep sleep were low (stage 3, 5.12 ± 3.08%, stage 4, 9.60 ± 7.10%). Our study group was divided into two based on age: individuals aged30 years (n = 152) and30 years (n = 29). REM latency on PSG was shorter (t = 2.96, p = 0.004) and sleep onset REM (SOREM) on MSLT was higher (t = 2.56, p = 0.011) in the older group than in the younger group. Cataplexy is seen in most patients with narcolepsy. In older patients, REM latency on PSG is shorter and the number of SOREM on MSLT is higher.

A neurosyphilis case presenting with dementia Neurosyphilis is an infection of central nervous system caused by Treponema pallidum and may present with neuropsychiatric symptoms. Neurosyphilis can mimic virtually any psychiatric disorder, including depression, mania, psychosis, personality changes, delirium and dementia. Neurosyphilis is a mysterious disease because it imitates psychiatric diseases leading difficulties in differential diagnosis. In addition, antibiotics may change its natural course, and therefore, its clinical manifestations. Mild or various forms of neurosyphillis may present, instead of the conventional form. In this paper, a case who could not have been detected at primary or secondary stages and presented with neuropsychological symptoms (tertiary neurosyphilis) was discussed.

Objective: In this study, we measured event related potentials (ERPs) in a male sample of antisocial personality disorder (ASPD) patients who were free of substance and alcohol abuse and compared t...

OZET: Olanzapin kullanimina bagli gelisen bir gec diskinezi olgusu Gec diskinezi (GD) , antipsikotik kullanimi sonrasinda dilde, cenede, govdede, kol ve bacaklarda ortaya cikan anormal istemsiz hareketler kompleksidir. Bu hareketler cogunlukla koreiform, atetoid veya ritmik hareketlerdir. Antipsikotik kullaniminin neden oldugu GD tanisi icin, DSM-IV olcutlerine gore, bu istemsiz hareketlerin en az 4 hafta sureyle var olmasi, antipsikotik ilacin en az 3 ay, eger 60 yas ve ustunde ise en az 1 ay sure ile kullanil- masi gerekmektedir. Nigro-striatal bolgedeki dopamin reseptorlerini bloke eden yuksek potensli klasik antipsikotiklerin kullanimi ile GD gelisimi daha fazladir ve doz arttikca risk artmak - tadir. Risperidon, olanzapin, ketiapin, ziprasidon gibi atipik antipsikotikler daha dusuk GD gelisimi riskine sahiptir. Olanzapin, diger psikotrop ilaclara bagli geli- sen gec diskinezi olgularinin tedavisinde kullanilmakta- dir ve gec diskineziye yol actigi ile ilgili olgu sunumlari

Background Studies that have focused on the mitochondrial electron transport chain indicate that bipolar disorder (BD) is associated with pathology in mitochondrial function. These pathological processes occur in the brain circuits that regulate affective functions, emotions, and motor behaviors. The present study aimed to determine the relationship between mitochondrial complex dysfunction and BD. Methods The BD group included 32 male patients diagnosed with first-episode manic BD. The control group included 35 sociodemographically matched healthy males. Messenger ribonucleic acid (mRNA) was isolated from peripheral blood samples obtained from the patients and control group, and the mRNA levels of the NDUFV1 , NDUFV2 , and NDUFS1 genes of mitochondrial complex I and the UQCR10 gene of mitochondrial complex III were investigated. Results Significant differences were identified in complex I gene mRNA levels between the BD group ( n =32) and the control group ( n =35) for the following genes: NDUFV1 ( P =0.01), NDUFV2 ( P NDUFS1 ( P =0.02). The UQCR10 gene (complex III) mRNA level did not differ between the groups ( P =0.1). The mRNA levels of the four genes studied were lower at the 3-month follow-up; however, these differences were not significant ( P >0.05). Limitations All of the BD patients were in manic episodes; thus, we were unable to separately compare these levels with those during depressive and euthymic episodes. Conclusions The mRNA levels of all of the genes representing the subunits of mitochondrial complex I ( NDUFV1 , NDUFV2 , and NDUFS1 ) were significantly higher in the present study's BD patients during manic episodes than in the controls. With the data obtained from further research, biomarkers that could be used for the diagnosis and follow-up of neuropsychiatric disorders may be discovered.

INTRODUCTION Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting multiple systems, particularly the endocrine system. We propose to investigate the possible relationships among hormonal changes, levels of anxiety, depression, and anger in patients with PCOS. METHOD Forty-four female patients with PCOS and 44 body mass index (BMI )-matched healthy women participated in this study. We measured the sociodemographic features, some serum hormonal levels (insulin, gonadotropins, prolactin, dehydroepiandrosterone sulfate (DHEAS), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), 17 OH-progesterone, and total and free testosterone), and some other biochemical parameters of the participants. Also, all participants completed the Trait Anger-Anger Expression Scale (STAS), Beck Depression, and Beck Anxiety Inventories. We evaluated the psychiatric scale scores obtained from PCOS patients and control subjects. We used the independent-samples t-test for parametric data to evaluate normal distribution, and Mann-Whitney U-test was used for both abnormally distributed and nonparametric data. We used Pearson correlation analysis to evaluate the potential connection between the two groups' data. RESULTS The mean ages of the patients with PCOS and control subjects who participated in this study were 27.3±5.6 and 27.4±6.1 years, respectively. The measures of BMI, insulin, luteinizing hormone (LH), DHEAS, and total testosterone serum levels in the patient group were significantly higher than in the control group (p

Background The etiology of schizophrenia is not precisely known; however, mitochondrial function and cerebral energy metabolism abnormalities were determined to be possible factors associated with the etiology of schizophrenia. Impaired mitochondrial function negatively affects neuronal plasticity, and can cause cognitive deficits and behavioral abnormalities observed during the clinical course of schizophrenia. The present study aimed to investigate the relationship between the clinical features of schizophrenia, and mitochondrial complex activation, based on measurement of mRNA levels in the NDUFV1, NDUFV2, NDUFS1, and UQCR10 genes involved in the peripheral mitochondrial complex. Methods The study included 138 schizophrenia patients and 42 healthy controls. The schizophrenia group was divided into a chronic schizophrenia subgroup (n = 84) and a first-episode schizophrenia subgroup (n = 54). The symptoms profile and severity of disorder were evaluated using the Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and Brief Psychiatric Rating Scale (BPRS). Results The level of mRNA expression of NDUFV1, NDUFV2, and NDUFS1 was significantly higher in the schizophrenia group than in the control group. The mRNA level of NDUFV2 was positively correlated with BPRS and SAPS scores in the first-episode schizophrenia subgroup. Conclusion The findings showed that there was a positive correlation between gene mRNA levels and psychotic symptomatology, especially positive symptoms. Our results suggest that mRNA levels of the NDUFV1, NUDFV2, and NDUFS1 genes of complex I of the mitochondrial electron transport chain might become a possible peripheral marker for the diagnosis of schizophrenia.

Despite numerous studies investigating the dimensional and therapeutic effects of mandibular advancement splints (MASs), data regarding the effects of differently designed individual and non-adjustable MASs on the upper airway in fully dentate apneic subjects in the sagittal plane including comparison of these effects with a placebo device are sparse. The present study aimed to determine the dimensional changes in the sagittal plane created by differently designed MASs in the upper airway in fully dentate apneic subjects and to compare these changes with the effects of a placebo device. Magnetic resonance (MR) images of 9 dentate apneic subjects with 5 differently designed MASs and without a MAS were obtained. We measured the area of the entire pharynx (velopharynx, oropharynx, hypopharynx) on these MR images and compared the dimensional changes. The dimensional changes triggered by two specific MASs (75 % of the maximum mandibular protrusion with 5 mm vertical opening, and 75 % of the maximum mandibular protrusion with 10 mm of vertical opening) in the entire pharynx in the sagittal plane were statistically significant compared to the other MASs (p

Objectives To compare propofol and sodium thiopental as anesthetic agents for electroconvulsive therapy (ECT) in major depression with respect to clinical effect. Methods Participants were composed of 96 patients with depression who were administered either propofol or sodium thiopental as an anesthetic agent for bilateral ECT. The Hamilton Depression Rating Scale was administered at baseline and after 6 treatments. Algorithm-based charge dosing was used. Results There was a statistically significant difference between the groups regarding postintervention Hamilton Depression Rating Scale score. The preintervention mean (SD) scores in the propofol group and the sodium thiopental group were 37.3 (2.2) and 36.7 (1.2), respectively. The postintervention mean (SD) scores in the propofol group and the sodium thiopental group were 10.7 (1.8) and 13.4 (3.3), respectively. No correlation was found between clinical response and age, weight, and body mass index. There was no association between the groups' seizure time and duration of recovery. Conclusions In conclusion, propofol may improve major depressive disorder more than sodium thiopental in patients who are receiving ECT.

SUMMARY Objective: Although conflicting results have been obtained regarding P300 amplitude and latency in major depressive patients, most studies have reported that major depressive patients have smaller P300 amplitudes and longer latencies than healthy people. This study aimed to investigate the relationship between P300 and treatment response in major depressive disorder patients. Methods: Twenty-eight patients suffering from major depression who completed 12 weeks of follow-up appointments and 28 healthy people, whose age and gender were matched with patients, were included in the study. Event-related potentials (P300) were recorded for patients before and after treatment with sertraline (50-200 mg/day) for 12 weeks. Treatment response was defined as a 50% or greater decrease in a given patient’s total Hamilton Depression Rating Scale score. Pre-treatment and post-treatment P300 amplitude and latency values were compared for responders (n=18), non-responders (n=10) and healthy subjects. Results: No significant difference was found between the P300 amplitude values of responders, non-responders and healthy subjects before or after treatment. Pre-treatment P300 latencies of non-responders were significantly longer than latencies of responders and healthy subjects. After treatment for depression, P300 latency values of responders were normalized, but non-responders still maintained longer P300 latencies than responders and healthy subjects. Conclusion: These findings suggest that delayed P300 latency may be related to a non-response to sertraline treatment. No relation was found between P300 amplitude and treatment response.

Objective: Patients with bipolar disorder often suffer from persistent cognitive impairments. However, it is not described fully that these impairments are associated with episodes of the disorder. We aimed to study cognitive functions in same bipolar patients during their manic episodes and remission periods Method: Nine (9) male patients were recruited in this study. The mean age of the patients was 23.3. Bipolar disorder was diagnosed with Structured Clinical Interview for DSM-IV Clinical Version (SCID-I). Cognitive functions were evaluated during patients' manic episodes and when they were in remission at least 3 months. Patients with a score of Hamilton Depression Scale

The mental health of the person must be healthy for being responsible for the crime committed. In this study, socio-demographic and clinical characteristics as well as assessments about criminal responsibilities of the patients who were under forensic observation for crimes committed in the military environment was evaluated. Medical records of the 1,482 patients who were referred with the aim of forensic observation within a period of five years were studied retrospectively. The average age of the patients was 26.6 ± 8.2 years and education levels were 8.6 ± 2.2 years. Fifty-seven percent had a history of substance abuse, drug addiction rate was 1.2%. 22.3% of the cases were evaluated within the 32nd article of Turkish Penal Code (TPC). Diagnoses of patients assessed under 32nd article of TPC was psychotic disorder (61.9%), mental retardation (13.3%) and bipolar disorder (13%), respectively. 19.23% of the cases had previous criminal histories. Level of education of patients with a previous criminal history was lower (7.73 ± 1.36 years). There was also significant difference between groups with and without previous criminal history in terms of diagnosis of antisocial personality disorder and substance abuse history (p

Objectives: Defense mechanisms may be directly related to psychiatric diagnoses. There is an association between depression and maladaptive defenses, especially, the immature defenses. The aim of this study was to evaluate the defense mechanisms used by endogenous and non-endogenous patients by comparing those used by controls. Methods: The sample was composed of 92 treatment-naive patients with major depressive disorder (MDD; 46 endogenous type and 46 non-endogenous type) and 40 controls. The diagnosis of MDD in each participating patient was confirmed by means of the Structured Clinical Interview for DSM-IV, Turkish version, conducted by trained interviewers. Endogeneity of depression was assessed with Newcastle Depression Diagnostic Scale. Defense mechanisms were evaluated by using the Defense Style Questionnaire 40. Results: Immature defense mechanisms differentiated controls from all patients as well as they distinguished endogenous depressive patients from non-endogenous patients. The analyses indicated that endogeneity is characterized by passive-aggression, acting out, isolation, autistic fantasy, rationalization and somatization. Additionally, total scores of the immature defenses had a positive correlation with severity of depression in the endogenous group. Conclusions: The results of the present study showed evidence of some differences in defense mechanisms among endogenous depression and non-endogenous depression diagnoses, specifically the maintenance of a high immature defense style in endogenous depression patients when compared with non-endogenous depression patients.

The evidence about the role of oxidative stress on the pathophysiology of bipolar disorder (BD) has been increased recently. It has been considered that oxidative stress and its effects cause damage in the critical brain circuits regulating affective functions, emotions, motor behaviors and so that the symptoms seen in BD occur by the deterioration of mood-stabilizing mechanisms. In clinical trials, significant changes were determined in the BD patients’ levels of antioxidant enzymes, lipid peroxidation and nitric oxide. Because of the different clinical features of the disorder such as manic/hypomanic, depressive, or mixed episode, the data associated with oxidative stress might vary among the patients. Some mood stabilizers used in the treatment are known to have antioxidant effects. Normalization of the oxidative stress parameters had been reported in the treatment process of BD. It makes a positive contribution to the treatment process that these drugs increase the neurotrophic factors and protect against apoptosis as well as reducing the effects of oxidative stress. Reactive oxygen species occur with the escape of some electrons from the chain during their flow in the mitochondria complex and mitochondrial dysfunction develops after the inhibition of electron transport chain. Mitochondrial dysfunction found to be associated with the pathogenesis of BD. Mitochondrial dysfunction and oxidative stress may create symptoms of the BD secondary to the changes in intracellular signaling system, balance of intracellular calcium, and DNA structure. Using antioxidants, in addition to the treatment, is expected to provide positive contribution to the prognosis in bipolar patients. Systematic studies including each period of the disorder are needed for using the findings indicating deterioration of oxidative balance as biological markers in BD., Son dönemde oksidatif stresin iki uçlu bozukluğun (İUB) fizyopatolojisinde rolü olduğuna dair bulgular artış göstermektedir. Oksidatif stres ve etkilerinin, özellikle mizacı, emosyonları, motor davranışları düzenleyen kritik beyin devrelerinde hasara neden olduğu; böylece İUB’de görülen belirtilerin mizacı düzenleyen mekanizmalarda bozulma ile ortaya çıktığı düşünülmektedir. Klinik çalışmalarda, İUB hastalarında antioksidan enzim, lipid peroksidasyonu ve nitrik oksit düzeylerinde belirgin değişiklikler saptanmıştır. Hastalığın manik/hipomanik, depresif ya da karma dönem gibi farklı klinik görünümleri nedeniyle oksidatif stres ile ilişkili veriler farklılık gösterebilmektedir. Tedavide kullanılan bazı mizaç düzenleyicilerinin antioksidan özellikleri olduğu bilinmektedir. İUB’nin tedavi sürecinde oksidatif parametrelerde normalleşme bildirilmiştir. Bu ilaçların oksidatif stresi azaltıcı etkisi yanı sıra, nörotrofik faktörleri artırması ve hücre ölümüne karşı koruyucu olması, tedavi sürecine olumlu katkı yapmaktadır. Mitokondri kompleksinde elektron akışı sırasında bazı elektronların zincirden kaçması ile reaktif oksijen radikalleri oluşmakta ve elektron transport zincir inhibisyonu ile mitokondrial işlev bozukluğu gelişmektedir. İUB patogenezi ile mitokondrial işlev bozukluğu ilişkili bulunmuştur. Mitokondrial işlev bozukluğu ve oksidatif hasar, hücre içi sinyal sisteminde, hücre içi kalsiyum dengesinde ve DNA yapısında değişiklikler oluşturarak İUB belirtilerine neden olabilir. İUB’de tedaviye ek olarak antioksidan kullanılmasının hastalığın seyrine olumlu katkı sağlayabileceği düşünülmektedir. İUB’de oksidatif dengedeki bozulmayı gösteren bulguların biyolojik belirteç olarak kullanılabilmesi için, sistemli ve bozukluğun her dönemini kapsayacak çalışmalara ihtiyaç vardır.

Introduction Bipolar disorder usually begin at an early age and often need hospitalization. In this study, we aimed to investigate the clinical characteristics of patients with bipolar disorder Methods The data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined. Results 45 of 108 bipolar patients (41.6%) episodes of mania was just across diseases. 18 of these 45 patients were diagnosed with first-episode mania. Percentage of these patients according to their diagnosis index episode, mania was 65.7%; hypomania was 15.7%; hypomania and depressive episode was 18.5%. The number of entrants as a manic episode was approximately 3 times as depression disease beginners. Maximum rate of admission to clinic was in November and December (14.8% and 10.1%). The distribution of hospitalization rate was 21.2% in winter, 25.9 and 24% in spring and summer, 28.7% in autumn. The mean length of hospitalization was 22.4 ± 16.0 days and patients were hospitalized 2.75 ± 2.34 times during their diseases. Patients had manic episodes average of 3.1 ± 4.4 times and depresif episodes average of 1.4 ± 2.5 times during their diseases. Conclusions There is no consensus regarding the types of seizures in first episode bipolar disorder. The first period of mania or depression is likely close to each other. In our study, the most prominent was mania with 65.7%. Major depressive periods usually begin in winter and autumn and improves in summer.

Introduction Polycystic ovary syndrome (PCOS) is a common disease in women during the reproductive period. Studies have shown a reduction in the quality of life in patients with PCOS. But there is no consensus on which symptoms of PCOS influence the quality of life more. Aim In this study, we aimed to compare the quality of life, depression and anxiety levels of patients with PCOS to healthy controls. Methods 53 reproductive-age women with PCOS and 53 healthy women who admitted to obstetrics and gynecology outpatient clinic of a university hospital were included in the study. For the evaluation of the quality of life of all patients, Polycystic ovary syndrome quality of life scale (PCOS-Q), Beck depression and anxiety levels of depression (BDI) and Beck Anxiety Inventory (BAI) was used. Results While mean BDI scores were higher in patients with PCOS compared with control group, no significant difference was observed between the two groups in terms of BAI score. At the PCOS group; the total score of quality of life scale and the subscale scores of emotional deterioration, weight problems, infertility and menstrual disorders were significantly lower than the control group, but no significant difference was detected at the hirsutism subscale between the two groups. Conclusions PCOS has a negative impact on patients’ quality of life. To improve the quality of life of patients it should be taken into account the symptoms which are affecting the current state and the treatment should be planned toward this direction.

Introduction In the treatment of bipolar disorder, mood stabilizers (MS), antipsychotics (AP), antidepressants (AD) and anxiolytics can be used according to the type and severity of the episode. Aim The frequency of somatic and pharmacological treatments in hospitalized bipolar patients were investigated in this study. Methods In this study the data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined. Results The rate of the treatments for mania was %6.6 for MS, %88.8 for MS + AP and %4.4 for AP. For depressive episode it was %33.3 for MS+AD, %38.8 for MS+AP, %38.8 for MS+AD+AP. Lithium (55.5%) and valproic acid (42.5%) were the most preferred MS drugs. Average dose was 1330 ± 43.2 for lithium and 1118 ± 27.9 mg / day for valproic acid. Most frequently (46.2%) preferred antipsychotics was Olanzapine. Average dose was 16.1 ± 0.8 mg / day. 12.9% of the patients had received electroconvulsive therapy (ECT) at an average of 9.7 ± 5.2 sequences. Conclusions Lithium treatment in bipolar disorder seems to be first choice for the treatment and prevention of acute episodes. There is an increase in the using of the atypical antipsychotics as mood stabilizers. ECT may be an effective method for patients who do not respond to medications. Considering the diagnosis of patients hospitalized in our clinic, drug selection and treatment modalities were consistent with treatment guidelines.

Introduction The aim of this study was to compare the sociodemographic and clinic characteristics of patients with bipolar disorder type I with and without history of depressive episode. Method In this study the data of 108 bipolar type I patients who were admitted to psychiatry clinic of a university hospital due to manic episode between 2007–2009 were examined. Results According to these data, 16 of 108 bipolar disorder type I patients (14.8%) had inhabited at least 4 manic episodes throughout their lives and there was no history of depressive episode although the disease had continued at least 4 years. With and without a history of depressive episode of bipolar type I patients have not been identified differ in terms of sociodemographic and clinical characteristics, but patients not having a history of depressive episode during their lifetime was found to be more than the number of hospitalizations. Conclusion Current information seem to be not sufficient to define unipolar mania as a separate nosological class. Largescale, prospective designs and illuminating the pathophysiology and etiology studies needs to be done in this issue.

As a result of increasing evidence that the origins of many illnesses begin in fetal life, the importance of prenatal events are growing. Many animal and human studies have been made to reveal the effect of prenatal stress on psychopathology. In general, most of the studies of prenatal stress agree with negative feedback dysregulation and hyperactivity of hypothalamo pituitary adrenocortical axis. Evident findings of studies are; increased risk of birth complications, startle or distress in response to novel and surprising stimuli during infancy; lower Full Scale IQs, language abilities and attention deficiency in period of 3–5 years; increased risk of ADHD, anxiety symptoms, depressive disorder and impulsivity during adolescence. Additionally, timing of prenatal stress is also important and 12–22 weeks of gestation seems to be the most vulnerable period. The results underline the need for early prevention and intervention programs for highly anxious women during pregnancy. Administration of prenatal stress monitoring to public health programs or removing pregnant women who have been exposed to life events such as natural disaster, terror attack to secure areas that provide basic needs may be important.

Introduction Because of the different receptor profiles, atypical antipsychotics are known to cause metabolic changes such as increased weight gain, type 2 diabetes and hyperglycemia,. Aim In this study, we aimed to observe metabolic side effects of drug use of patients receiving antipsychotic medication in first-episode psychotic disorder. Methods 49 male patients who were hospitalized at Gulhane Military Medical Academy Psychiatry Department with a diagnosis of psychotic disorder according to DSM-IV criteria between May 2011–2012 were included in the study. Blood lipid profiles and liver and renal function tests of the patients before treatment and after 8 weeks of treatment were evaluated. Results Of the patients participating in the study of 16 were using olanzapine, 15 risperidone, 6 quetiapine, 5 aripiprazole and 7 haloperidol. There was no statistically significant difference between patients before and after treatment in terms of blood lipid profile, the liver and kidney functions. There was also no significant difference according to the antipsychotic drug used. Conclusions In studies with long-term follow-up of 6 months or 1 year or a short-term follow-up as 1 month with atypical antipsychotics these values usually seems to have changed. As a result of 2-month follow-up at our study, patients that were being treated with atypical antipsychotics have not shown any changes in the metabolic values.

Introduction Although the lifetime prevalence of bipolar disorder is not different between men and women, some of the features of the disease vary between the genders. Aim To compare the clinical and sociodemographic features of bipolar disorder according to gender. Methods In this study the data of 125 bipolar disorder tip I patients who had been admitted to Department of Psychiatry of Gulhane Military Medical Faculty between 2009–2011 were examined. Data of these patients were obtained by examining the patients files. Results 95 of 125 patients (%76.0) were male, and 30 (%24.0) were female. Age of disease onset in bipolar male patients was 22,5 ± 6,9; %6.3 had a history of suicid attempt and %11.6 had a history of substance abuse. Age of disease onset in bipolar female patients was 28,7 ± 9.7. %23.3 had a history of suicide attempt. There was no history of substance abuse in female patients. Psychotic features and history of substance abuse were more prominent in men. The later age of disease onset and longer duration of hospitalization were determined in women. Conclusion Our results were appeared to be in line with the results of the studies about gender differences in bipolar disorder. Making prospective studies about this subject is considered to be useful to determine the epidemiological characteristics of mood disorders.

Introduction PCOS is a syndrome of the heterogeneous nature, affecting multiple systems, particularly the endocrine system. We propose to investigate the possible relationships among hormonal changes, levels of anxiety, depression, and anger in patients with PCOS. Method Fourty four female patients with PCOS and 44 BMI (Body Mass Index)-matched healthy women participated in this study. We measured the sociodemographic features, some serum hormonal levels (insulin, gonadotropins, prolactin, dehydroepiandrosterone sulfate (DHEAS), TSH, T3, T4, 17 OH-Progesterone, total and free testosterone) and some other biochemical parameters of the participants. Also, all participants completed Trait Anger-Anger Expression Scale (STAS), Beck Depression and Beck Anxiety Inventories. Results The mean ages of the patients with PCOS and control subjects were 27.3 ± 5.6 and 27.4 ± 6.1 years, respectively. The measures of BMI, insulin, LH, DHEAS, and total testosterone serum levels in the patient group were significantly higher than the control group (p Conclusion Anxiety symptoms indicate stronger relationship compared to the depression with the DHEAS serum levels via autonomic nervous system, considering GABA antagonistic effect of DHEAS. Obesity, hirsutism, and infertility may reduce selfconfidence, and create depressive symptoms in patients with PCOS. In addition, changes in the hormonal levels may lead to anxiety directly. Possibly, depressive symptoms are a secondary reflection of these changes.

This study was made in order to determine the prevalence of body dysmorphic disorder (BDD) symptoms in a group of male high school students at Turkey. The study was consisted of high school students from six schools at five cities (Ankara, Istanbul, Izmir, Bursa, Balikesir). Questionnaires were applied to 865 students who were selected through stratified random sampling method from 6760 students. Students\' answers to the self-report forms were evaluated. For assessing body dysmorphic disorder symptoms, a semi-structured questionnaire based on DSM-IV diagnostic criteria was used. In addition, the body regions which they were experiencing problems were also evaluated. 47.6 % of the participants\' stated that they perceive that they actually have a physical defect. Symptoms were present for more than 5 years at 15.3 % of participants. Defects were thought to be most often at their teeth (30.3 %), head/face areas (21.4 %), hair (21.1 %), nose (18.7 %), general muscle structure (14.3 %) abdominal/hip structures (12.1 %). 2.3 % of the participants\' stated that their daily activities were negatively affected and 2.1 % stated that they were not participating in social activities for this reason. Results show that symptoms of body dysmorphic disorder are common in adolescents and affects daily functioning negatively.

Objective: In explaining the association between depression and immune system pro-inflammatory cytokines have come to the fore and there appears to be an increase in particular at the cellular immune response. Neopterin measurements enable monitoring of the cellular immune response although its specific function is still not fully described. Similarly, haptoglobin (Hp), a positive acute phase protein, has been mentioned as well. In this study, we aimed to investigate the effects of depressive episodes on serum levels of neopterin and Hp by comparing serum haptoglobin and neopterin levels of the depressive patients in their first attack with those of depression patients suffering from recurrent attacks, and with the healthy control group. Method: Eighty patients who admitted to the outpatient psychiatry clinic of Ankara Gulhane Military Medical Academy (GMMF) were included in the study. Fourty-four individuals were being followed up with a diagnosis of first episode depression. There were 36 patients in the recurrent major depression (MD) group. The control group consisted of 41 healthy individuals. Of recurrent MD patients, 22 patients were in their second episode, 16 patients were in their third attack and 6 patients had four episodes or more. Severity of depression was evaluated with 17-item Hamilton Depression Rating Scale (HAM-D). Peripheral venous blood samples were collected from participants to determine complete blood count, routine biochemistry, serum neopterin, and haptoglobin measurements. The levels of serum neopterin and haptoglobin were measured by using the samples that were collected between the hours of 8:00 am and 11:00 am after 12 hour fasting during the previous night. Results: There was no significant difference between the three groups in terms of gender, age, educational level, and smoking. There was also not significant difference between the first episode MD and recurrent MD groups for HAM-D scores. No significance was detected between the first episode MD and control groups in terms of serum Hp and neopterin levels. In the recurrent MD group serum Hp and neopterin levels were higher than those of the first episode MD patients and the control subjects. HAM-D scores of MD patients (both first-episode MD and recurrent MD group) were correlated with serum levels of Hp, but there was no correlation between serum neopterin levels and HAM-D scores. Conclusion: The independent factor affecting the neopterin and Hp levels in patients with MD was found as the number of episodes of depression. Recurrent episodes have resulted with increased levels of both markers. We believe that this finding is important. Our findings support the hypothesis that major depressive disorder is generally associated with widespread inflammatory reaction and severity of depressive symptoms are positively correlated with the increase in inflammatory markers. Serum levels of Hp were associated with depression severity in patients who had a single episode as well as patients with multiple episodes. The same relationship was not found for neopterin. Further studies are needed to determine the importance of this difference observed between the two markers and also etiological significance of them.

Motor evoked potentials from peripheral nerves, spinal cord or muscle can be recorded by stimulation of the motor cortex and motor pathways in the central nervous system with transcranial magnetic stimulation which is a neurophysiological analysis method. This method allows investigation the mechanism of diseases which cause changes in the excitability of cortical motor areas. Similarly, it was used in determining the effects of psychotropic drugs on cortical activity and electrophysiological measurement of aggressive behavior Transcranial magnetic stimulation studies in the field of psychiatry are focused on etiopathogenesis of pathologies such as schizophrenia, obsessive-compulsive disorder, attention deficit hyperactivity disorder and substance abuse.

However the lifetime prevalence of bipolar disorder is not different between men and women, some of the features of the disease vary between the genders. The aim of this study was to compare the clinical and sociodemographic features of bipolar disorder according to gender. In this study the data of 125 bipolar disorder tip I patients who had been admitted to Department of Psychiatry of Gulhane Military Medical Faculty between 2009-2011 were examined. Data of these patients were obtained by examining the patients files . 95 of 125 patients (%76.0) were male, and 30 (%24.0) were female. Age of disease onset in bipolar male patients was 22,5 ± 6,9; %6.3 had a history of suicid attempt and %11.6 had a history of substance abuse. Age of disease onset in bipolar female patients was 28,7 ± 9.7. %23.3 had a history of suicide attempt. There was no history of substance abuse in female patients. Psychotic features and history of substance abuse were more prominent in men. The later age of disease onset and longer duration of hospitalization were determined in women. Our results were appeared to be in line with the results of the studies about gender differences in bipolar disorder. Making prospective studies about this subject is considered to be useful to determine the epidemiological characteristics of mood disorders.